DEATH CERTIFICATE
SAMUEL MULLENS

Date  19 September 1921
Cert: #  22210
Name:  Samuel MULLENS
Place of Death: Voting Pct. #1 Hindman, Knott Co., KY
Male, White, Married
Birth Date:  15 August 1846 
Age:  75 years, 01 months, 04 days
Occupation:  Farmer
Place of Birth:  Kentucky
Name of Father:  John MULLENS 
Birthplace Father:  Kentucky 
Maiden Name of Mother:  Mandy FRANCIS
Birthplace Mother:  Kentucky 
Informant:  (blank)
Death Date:  19 September 1921
Cause of Death:  Lobar Pneumonia
Signed:  M. F. Kelley, M.D.
Burial Place:  Francis Cemetery 
Date of Burial:  20 September 1921 
Undertaker:  John Everidge, Hindman, Ky. 
File Date:  06 November 1921 
Transcribed by Debbie Tamborski, 27 January 2009